Ketchikan Galley - Past Performance Questionnaire (PPQ).doc

70Z08424QKETC0003

Full Food Services

USCG Base Ketchikan

The United States Coast Guard, Operational Logistics Command is currently procuring Full Food Services as required by the U.S. Coast Guard at Base Ketchikan, Ketchikan, AK under solicitation 70Z08424QKETC0003. As a result, we are performing a past performance survey and reference investigation on potential contractors for the upcoming contract.

The information contained herein is considered “Source Selection Information” in accordance with FAR 3.104. Therefore, it is asked that you treat it accordingly. While the results of the overall past performance survey may be discussed with the contractor, FAR Part 15.610 and 15.1004 prohibits the release of the name of the individual responding to the survey.

Responses to this questionnaire should be EMAILED TO Susan Lawson, LOG 92 at susan.b.lawson@uscg.mil.

Should you have any questions concerning this survey, please contact the above named person at (510) 519-0550.

This portion is to be completed by the Offeror.

Contract Number:

Offeror’s Company Name:__________________________________________________________

Address:

Telephone/Fax Number: ___________________________________________________________

Point of Contact:

Email:

Was work performed as a subcontractor under a prime contract? No If yes, include, Yes Prime Contract Number: ___________________________________________________________

Prime Contractor’s Name: __________________________________________________________

Address:

Telephone/Fax Number: ___________________________________________________________

Point of Contact:

Offeror Name: _________________________________________ Solicitation 70Z08424QKETC0003 Project Title and Detailed Description of Work for which the Contractor was responsible to perform:

This portion is to be completed by the Respondent

Name and Title of Evaluator: _________________________________________________________________

Company Name: __________________________________________________________________

Address:

Telephone/Fax Number: _____________________________________________________________________

Point of Contact:

1. Contractor performed as Key Personnel Subcontractor Prime Contractor

2. The description of work as stated above does not accurately describe the work that was performed by Contractor being rated.

accurately or

3. The contract was IAW (check all that apply): Subcontracting Sole Source Davis Bacon SCA IDIQ T&M CR FFP

4. The total dollar value awarded: _________________________________________________

5. The total dollar value performed to date: _________________________________________

6. The Period of Performance awarded: ____________________________________________

7. The Period of Performance performed to date: _____________________________________

Offeror Name: _________________________________________ Solicitation 70Z08424QKETC0003 Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF E, G, M or U.

Place an “X” in the appropriate column using the definitions matrix above.

QUALITY

SCHEDULE

Offeror Name: _________________________________________ Solicitation 70Z08424QDL930005

COST CONTROL

MANAGEMENT

REGULATORY

ADDITIONAL COMMENTS ON ANY RATING ELEMENT CAN BE MADE BELOW:

Offeror Name: _________________________________________ Solicitation 70Z08424QKETC0003